Parkinsonism and dystonia caused by the illicit use of ephedrone—A longitudinal study
Identifieur interne : 002705 ( Main/Curation ); précédent : 002704; suivant : 002706Parkinsonism and dystonia caused by the illicit use of ephedrone—A longitudinal study
Auteurs : Marianna Selikhova [Royaume-Uni, Russie] ; Ljuda Fedoryshyn [Ukraine] ; Yuri Matviyenko [Ukraine] ; Irena Komnatska [Ukraine] ; Marianna Kyrylchuk [Ukraine] ; Lesrek Krolicki [Pologne] ; Andrzej Friedman [Pologne] ; Andrew Taylor [Royaume-Uni] ; H. Rolf J Ger [Royaume-Uni] ; Andrew Lees (neurologue) [Royaume-Uni] ; Yanush Sanotsky [Ukraine]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-11-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adolescent, Adult, Brain (pathology), Brain (radionuclide imaging), Dystonia, Dystonic Disorders (chemically induced), Dystonic Disorders (pathology), Dystonic Disorders (physiopathology), Dystonic Disorders (radionuclide imaging), Ephedrine, Humans, Longitudinal Studies, Magnetic Resonance Imaging (methods), Male, Manganese (deficiency), Manganese (metabolism), Middle Aged, Nervous system diseases, Neurologic Examination, Pallidum, Parkinsonian Disorders (chemically induced), Parkinsonian Disorders (pathology), Parkinsonian Disorders (physiopathology), Parkinsonian Disorders (radionuclide imaging), Parkinsonism, Propiophenones (poisoning), Street Drugs (poisoning), Tomography, Emission-Computed, Single-Photon (methods), Young Adult, dystonia, ephedrine, globus pallidum, manganism.
- MESH :
- chemical , deficiency : Manganese.
- chemically induced : Dystonic Disorders, Parkinsonian Disorders.
- chemical , metabolism : Manganese.
- methods : Magnetic Resonance Imaging, Tomography, Emission-Computed, Single-Photon.
- pathology : Brain, Dystonic Disorders, Parkinsonian Disorders.
- physiopathology : Dystonic Disorders, Parkinsonian Disorders.
- chemical , poisoning : Propiophenones, Street Drugs.
- radionuclide imaging : Brain, Dystonic Disorders, Parkinsonian Disorders.
- Adolescent, Adult, Humans, Longitudinal Studies, Male, Middle Aged, Neurologic Examination, Young Adult.
Abstract
A neurological syndrome characterized by levodopa unresponsive bradykinesia, retropulsion with falls backwards, dysarthria, gait disturbance, dystonia, and emotional lability was identified in 13 male opiate addicts following the prolonged intravenous use of ephedrone (methcathinone), a central nervous stimulant prepared from pseudoephedrine, potassium permanganate, and vinegar. The natural history, response to treatment, and clinical features has been studied, and MR and dopamine transporter SPECT brain imaging were carried out. Pubic hair was sampled for manganese. The clinical and radiological picture closely resembled previous reports of chronic manganese poisoning and increased mean manganese level in pubic hair observed for at least 1 year after cessation of ephedrone. Odor identification was intact. Cognitive assessment showed a mild executive dysfunction and a mild depression. DaTSCANs were all normal. The neurological syndrome bears some similarities to PSP but differs from Parkinson's disease. Delayed neurological progression despite discontinuation of ephedrone occurred in one‐third of cases. Ephedrone poisoning should be considered as a possible cause of secondary Parkinsonism in young adults, particularly from Eastern Europe. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22290
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<term>Adult</term>
<term>Brain (pathology)</term>
<term>Brain (radionuclide imaging)</term>
<term>Dystonia</term>
<term>Dystonic Disorders (chemically induced)</term>
<term>Dystonic Disorders (pathology)</term>
<term>Dystonic Disorders (physiopathology)</term>
<term>Dystonic Disorders (radionuclide imaging)</term>
<term>Ephedrine</term>
<term>Humans</term>
<term>Longitudinal Studies</term>
<term>Magnetic Resonance Imaging (methods)</term>
<term>Male</term>
<term>Manganese (deficiency)</term>
<term>Manganese (metabolism)</term>
<term>Middle Aged</term>
<term>Nervous system diseases</term>
<term>Neurologic Examination</term>
<term>Pallidum</term>
<term>Parkinsonian Disorders (chemically induced)</term>
<term>Parkinsonian Disorders (pathology)</term>
<term>Parkinsonian Disorders (physiopathology)</term>
<term>Parkinsonian Disorders (radionuclide imaging)</term>
<term>Parkinsonism</term>
<term>Propiophenones (poisoning)</term>
<term>Street Drugs (poisoning)</term>
<term>Tomography, Emission-Computed, Single-Photon (methods)</term>
<term>Young Adult</term>
<term>dystonia</term>
<term>ephedrine</term>
<term>globus pallidum</term>
<term>manganism</term>
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<term>Parkinsonian Disorders</term>
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<front><div type="abstract" xml:lang="en">A neurological syndrome characterized by levodopa unresponsive bradykinesia, retropulsion with falls backwards, dysarthria, gait disturbance, dystonia, and emotional lability was identified in 13 male opiate addicts following the prolonged intravenous use of ephedrone (methcathinone), a central nervous stimulant prepared from pseudoephedrine, potassium permanganate, and vinegar. The natural history, response to treatment, and clinical features has been studied, and MR and dopamine transporter SPECT brain imaging were carried out. Pubic hair was sampled for manganese. The clinical and radiological picture closely resembled previous reports of chronic manganese poisoning and increased mean manganese level in pubic hair observed for at least 1 year after cessation of ephedrone. Odor identification was intact. Cognitive assessment showed a mild executive dysfunction and a mild depression. DaTSCANs were all normal. The neurological syndrome bears some similarities to PSP but differs from Parkinson's disease. Delayed neurological progression despite discontinuation of ephedrone occurred in one‐third of cases. Ephedrone poisoning should be considered as a possible cause of secondary Parkinsonism in young adults, particularly from Eastern Europe. © 2008 Movement Disorder Society</div>
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</inist:fA14>
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<wicri:noRegion>Surrey</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="J Ger, H Rolf" sort="J Ger, H Rolf" uniqKey="J Ger H" first="H. Rolf" last="J Ger">H. Rolf J Ger</name>
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<s3>GBR</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Department of Neuroimaging, Institute of Neurology. UCL</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name>
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<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</wicri:noRegion>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<orgName>National Hospital for Neurology and Neurosurgery</orgName>
</affiliation>
</author>
<author><name sortKey="Sanotsky, Yanush" sort="Sanotsky, Yanush" uniqKey="Sanotsky Y" first="Yanush" last="Sanotsky">Yanush Sanotsky</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Lviv Regional Clinical Hospital</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">09-0038026</idno>
<date when="2008">2008</date>
<idno type="stanalyst">PASCAL 09-0038026 INIST</idno>
<idno type="RBID">Pascal:09-0038026</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">001042</idno>
<idno type="wicri:Area/PascalFrancis/Curation">001C77</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">001147</idno>
<idno type="wicri:doubleKey">0885-3185:2008:Selikhova M:parkinsonism:and:dystonia</idno>
<idno type="wicri:Area/Main/Merge">003755</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Parkinsonism and Dystonia Caused by the Illicit Use of Ephedrone : A Longitudinal Study</title>
<author><name sortKey="Selikhova, Marianna" sort="Selikhova, Marianna" uniqKey="Selikhova M" first="Marianna" last="Selikhova">Marianna Selikhova</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</s1>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Russian State Medical University</s1>
<s2>Moscow</s2>
<s3>RUS</s3>
<sZ>1 aut.</sZ>
</inist:fA14>
<country>Russie</country>
<placeName><settlement type="city">Moscou</settlement>
<region>District fédéral central</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fedoryshyn, Ljuda" sort="Fedoryshyn, Ljuda" uniqKey="Fedoryshyn L" first="Ljuda" last="Fedoryshyn">Ljuda Fedoryshyn</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Lviv Regional Clinical Hospital</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Matviyenko, Yuri" sort="Matviyenko, Yuri" uniqKey="Matviyenko Y" first="Yuri" last="Matviyenko">Yuri Matviyenko</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Neurology, Danylo Halytsky Lviv National Medical University</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Komnatska, Irena" sort="Komnatska, Irena" uniqKey="Komnatska I" first="Irena" last="Komnatska">Irena Komnatska</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of MRI, Central Hospital of the Lviv Regional Railway</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kyrylchuk, Marianna" sort="Kyrylchuk, Marianna" uniqKey="Kyrylchuk M" first="Marianna" last="Kyrylchuk">Marianna Kyrylchuk</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Lviv Regional Clinical Hospital</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Krolicki, Lesrek" sort="Krolicki, Lesrek" uniqKey="Krolicki L" first="Lesrek" last="Krolicki">Lesrek Krolicki</name>
<affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Nuclear Medicine, Medical University of Warsaw</s1>
<s2>Warsaw</s2>
<s3>POL</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Pologne</country>
<wicri:noRegion>Warsaw</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Friedman, Andrzej" sort="Friedman, Andrzej" uniqKey="Friedman A" first="Andrzej" last="Friedman">Andrzej Friedman</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Neurology, Medical University of Warsaw</s1>
<s2>Warsaw</s2>
<s3>POL</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>Pologne</country>
<wicri:noRegion>Warsaw</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Taylor, Andrew" sort="Taylor, Andrew" uniqKey="Taylor A" first="Andrew" last="Taylor">Andrew Taylor</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre for Clinical Science and Measurement, University of Surrey, Guildford</s1>
<s2>Surrey</s2>
<s3>GBR</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Surrey</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="J Ger, H Rolf" sort="J Ger, H Rolf" uniqKey="J Ger H" first="H. Rolf" last="J Ger">H. Rolf J Ger</name>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Neuroimaging, Institute of Neurology. UCL</s1>
<s3>GBR</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Department of Neuroimaging, Institute of Neurology. UCL</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</s1>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</wicri:noRegion>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<orgName>National Hospital for Neurology and Neurosurgery</orgName>
</affiliation>
</author>
<author><name sortKey="Sanotsky, Yanush" sort="Sanotsky, Yanush" uniqKey="Sanotsky Y" first="Yanush" last="Sanotsky">Yanush Sanotsky</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Lviv Regional Clinical Hospital</s1>
<s2>Lviv</s2>
<s3>UKR</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Ukraine</country>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Movement disorders</title>
<title level="j" type="abbreviated">Mov. disord.</title>
<idno type="ISSN">0885-3185</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Movement disorders</title>
<title level="j" type="abbreviated">Mov. disord.</title>
<idno type="ISSN">0885-3185</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dystonia</term>
<term>Ephedrine</term>
<term>Nervous system diseases</term>
<term>Pallidum</term>
<term>Parkinsonism</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinsonisme</term>
<term>Dystonie</term>
<term>Pathologie du système nerveux</term>
<term>Ephédrine</term>
<term>Pallidum</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">A neurological syndrome characterized by levodopa unresponsive bradykinesia, retropulsion with falls backwards, dysarthria, gait disturbance, dystonia, and emotional lability was identified in 13 male opiate addicts following the prolonged intravenous use of ephedrone (methcathinone), a central nervous stimulant prepared from pseudoephedrine, potassium permanganate, and vinegar. The natural history, response to treatment, and clinical features has been studied, and MR and dopamine transporter SPECT brain imaging were carried out. Pubic hair was sampled for manganese. The clinical and radiological picture closely resembled previous reports of chronic manganese poisoning and increased mean manganese level in pubic hair observed for at least 1 year after cessation of ephedrone. Odor identification was intact. Cognitive assessment showed a mild executive dysfunction and a mild depression. DaTSCANs were all normal. The neurological syndrome bears some similarities to PSP but differs from Parkinson's disease. Delayed neurological progression despite discontinuation of ephedrone occurred in one-third of cases. Ephedrone poisoning should be considered as a possible cause of secondary Parkinsonism in young adults, particularly from Eastern Europe.</div>
</front>
</TEI>
</INIST>
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<author><name sortKey="Selikhova, Marianna" sort="Selikhova, Marianna" uniqKey="Selikhova M" first="Marianna" last="Selikhova">Marianna Selikhova</name>
</author>
<author><name sortKey="Fedoryshyn, Ljuda" sort="Fedoryshyn, Ljuda" uniqKey="Fedoryshyn L" first="Ljuda" last="Fedoryshyn">Ljuda Fedoryshyn</name>
</author>
<author><name sortKey="Matviyenko, Yuri" sort="Matviyenko, Yuri" uniqKey="Matviyenko Y" first="Yuri" last="Matviyenko">Yuri Matviyenko</name>
</author>
<author><name sortKey="Komnatska, Irena" sort="Komnatska, Irena" uniqKey="Komnatska I" first="Irena" last="Komnatska">Irena Komnatska</name>
</author>
<author><name sortKey="Kyrylchuk, Marianna" sort="Kyrylchuk, Marianna" uniqKey="Kyrylchuk M" first="Marianna" last="Kyrylchuk">Marianna Kyrylchuk</name>
</author>
<author><name sortKey="Krolicki, Lesrek" sort="Krolicki, Lesrek" uniqKey="Krolicki L" first="Lesrek" last="Krolicki">Lesrek Krolicki</name>
</author>
<author><name sortKey="Friedman, Andrzej" sort="Friedman, Andrzej" uniqKey="Friedman A" first="Andrzej" last="Friedman">Andrzej Friedman</name>
</author>
<author><name sortKey="Taylor, Andrew" sort="Taylor, Andrew" uniqKey="Taylor A" first="Andrew" last="Taylor">Andrew Taylor</name>
</author>
<author><name sortKey="J Ger, H Rolf" sort="J Ger, H Rolf" uniqKey="J Ger H" first="H. Rolf" last="J Ger">H. Rolf J Ger</name>
</author>
<author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name>
<affiliation><country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<orgName>National Hospital for Neurology and Neurosurgery</orgName>
</affiliation>
</author>
<author><name sortKey="Sanotsky, Yanush" sort="Sanotsky, Yanush" uniqKey="Sanotsky Y" first="Yanush" last="Sanotsky">Yanush Sanotsky</name>
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</titleStmt>
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<idno type="wicri:source">PubMed</idno>
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<idno type="wicri:Area/PubMed/Corpus">002032</idno>
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<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Parkinsonism and dystonia caused by the illicit use of ephedrone—A longitudinal study</title>
<author><name sortKey="Selikhova, Marianna" sort="Selikhova, Marianna" uniqKey="Selikhova M" first="Marianna" last="Selikhova">Marianna Selikhova</name>
<affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</wicri:regionArea>
<wicri:noRegion>UCL</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3"><country xml:lang="fr">Russie</country>
<wicri:regionArea>Department of Neurology, Russian State Medical University, Moscow</wicri:regionArea>
<placeName><settlement type="city">Moscou</settlement>
<region>District fédéral central</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fedoryshyn, Ljuda" sort="Fedoryshyn, Ljuda" uniqKey="Fedoryshyn L" first="Ljuda" last="Fedoryshyn">Ljuda Fedoryshyn</name>
<affiliation wicri:level="1"><country xml:lang="fr">Ukraine</country>
<wicri:regionArea>Department of Neurology, Lviv Regional Clinical Hospital, Lviv</wicri:regionArea>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Matviyenko, Yuri" sort="Matviyenko, Yuri" uniqKey="Matviyenko Y" first="Yuri" last="Matviyenko">Yuri Matviyenko</name>
<affiliation wicri:level="1"><country xml:lang="fr">Ukraine</country>
<wicri:regionArea>Department of Neurology, Danylo Halytsky Lviv National Medical University, Lviv</wicri:regionArea>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Komnatska, Irena" sort="Komnatska, Irena" uniqKey="Komnatska I" first="Irena" last="Komnatska">Irena Komnatska</name>
<affiliation wicri:level="1"><country xml:lang="fr">Ukraine</country>
<wicri:regionArea>Department of MRI, Central Hospital of the Lviv Regional Railway, Lviv</wicri:regionArea>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kyrylchuk, Marianna" sort="Kyrylchuk, Marianna" uniqKey="Kyrylchuk M" first="Marianna" last="Kyrylchuk">Marianna Kyrylchuk</name>
<affiliation wicri:level="1"><country xml:lang="fr">Ukraine</country>
<wicri:regionArea>Department of Neurology, Lviv Regional Clinical Hospital, Lviv</wicri:regionArea>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Krolicki, Lesrek" sort="Krolicki, Lesrek" uniqKey="Krolicki L" first="Lesrek" last="Krolicki">Lesrek Krolicki</name>
<affiliation wicri:level="1"><country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Nuclear Medicine, Medical University of Warsaw, Warsaw</wicri:regionArea>
<wicri:noRegion>Warsaw</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Friedman, Andrzej" sort="Friedman, Andrzej" uniqKey="Friedman A" first="Andrzej" last="Friedman">Andrzej Friedman</name>
<affiliation wicri:level="1"><country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Neurology, Medical University of Warsaw, Warsaw</wicri:regionArea>
<wicri:noRegion>Warsaw</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Taylor, Andrew" sort="Taylor, Andrew" uniqKey="Taylor A" first="Andrew" last="Taylor">Andrew Taylor</name>
<affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Clinical Science and Measurement, University of Surrey, Guildford, Surrey</wicri:regionArea>
<wicri:noRegion>Surrey</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="J Ger, H Rolf" sort="J Ger, H Rolf" uniqKey="J Ger H" first="H. Rolf" last="J Ger">H. Rolf J Ger</name>
<affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neuroimaging, Institute of Neurology, UCL</wicri:regionArea>
<wicri:noRegion>UCL</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees (neurologue)</name>
<affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Neurology, Reta Lila Weston Institute of Neurological Studies, UCL</wicri:regionArea>
<wicri:noRegion>UCL</wicri:noRegion>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
<orgName>National Hospital for Neurology and Neurosurgery</orgName>
</affiliation>
</author>
<author><name sortKey="Sanotsky, Yanush" sort="Sanotsky, Yanush" uniqKey="Sanotsky Y" first="Yanush" last="Sanotsky">Yanush Sanotsky</name>
<affiliation wicri:level="1"><country xml:lang="fr">Ukraine</country>
<wicri:regionArea>Department of Neurology, Lviv Regional Clinical Hospital, Lviv</wicri:regionArea>
<wicri:noRegion>Lviv</wicri:noRegion>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Movement Disorders</title>
<title level="j" type="sub">Official Journal of the Movement Disorder Society</title>
<title level="j" type="abbrev">Mov. Disord.</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<pubPlace>Hoboken</pubPlace>
<date type="published" when="2008-11-15">2008-11-15</date>
<biblScope unit="vol">23</biblScope>
<biblScope unit="issue">15</biblScope>
<biblScope unit="page" from="2224">2224</biblScope>
<biblScope unit="page" to="2231">2231</biblScope>
</imprint>
<idno type="ISSN">0885-3185</idno>
</series>
<idno type="istex">A5B9BF0F3432F8C3619BD658411FA5258C39BFB5</idno>
<idno type="DOI">10.1002/mds.22290</idno>
<idno type="ArticleID">MDS22290</idno>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0885-3185</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Brain (pathology)</term>
<term>Brain (radionuclide imaging)</term>
<term>Dystonic Disorders (chemically induced)</term>
<term>Dystonic Disorders (pathology)</term>
<term>Dystonic Disorders (physiopathology)</term>
<term>Dystonic Disorders (radionuclide imaging)</term>
<term>Humans</term>
<term>Longitudinal Studies</term>
<term>Magnetic Resonance Imaging (methods)</term>
<term>Male</term>
<term>Manganese (deficiency)</term>
<term>Manganese (metabolism)</term>
<term>Middle Aged</term>
<term>Neurologic Examination</term>
<term>Parkinsonian Disorders (chemically induced)</term>
<term>Parkinsonian Disorders (pathology)</term>
<term>Parkinsonian Disorders (physiopathology)</term>
<term>Parkinsonian Disorders (radionuclide imaging)</term>
<term>Parkinsonism</term>
<term>Propiophenones (poisoning)</term>
<term>Street Drugs (poisoning)</term>
<term>Tomography, Emission-Computed, Single-Photon (methods)</term>
<term>Young Adult</term>
<term>dystonia</term>
<term>ephedrine</term>
<term>globus pallidum</term>
<term>manganism</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="deficiency" xml:lang="en"><term>Manganese</term>
</keywords>
<keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Dystonic Disorders</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Manganese</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Magnetic Resonance Imaging</term>
<term>Tomography, Emission-Computed, Single-Photon</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain</term>
<term>Dystonic Disorders</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dystonic Disorders</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="poisoning" xml:lang="en"><term>Propiophenones</term>
<term>Street Drugs</term>
</keywords>
<keywords scheme="MESH" qualifier="radionuclide imaging" xml:lang="en"><term>Brain</term>
<term>Dystonic Disorders</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Humans</term>
<term>Longitudinal Studies</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination</term>
<term>Young Adult</term>
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<front><div type="abstract" xml:lang="en">A neurological syndrome characterized by levodopa unresponsive bradykinesia, retropulsion with falls backwards, dysarthria, gait disturbance, dystonia, and emotional lability was identified in 13 male opiate addicts following the prolonged intravenous use of ephedrone (methcathinone), a central nervous stimulant prepared from pseudoephedrine, potassium permanganate, and vinegar. The natural history, response to treatment, and clinical features has been studied, and MR and dopamine transporter SPECT brain imaging were carried out. Pubic hair was sampled for manganese. The clinical and radiological picture closely resembled previous reports of chronic manganese poisoning and increased mean manganese level in pubic hair observed for at least 1 year after cessation of ephedrone. Odor identification was intact. Cognitive assessment showed a mild executive dysfunction and a mild depression. DaTSCANs were all normal. The neurological syndrome bears some similarities to PSP but differs from Parkinson's disease. Delayed neurological progression despite discontinuation of ephedrone occurred in one‐third of cases. Ephedrone poisoning should be considered as a possible cause of secondary Parkinsonism in young adults, particularly from Eastern Europe. © 2008 Movement Disorder Society</div>
</front>
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